Featured Speakers Bring Insights and Strategies to 8th Annual RISE Summit “Best Practices and Essential Strategies for Managing Risk, Quality, Revenue and Data Analytics"

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“Predictive Modeling Analytics and Strategies for Personalized Care Management” for Medicare Advantage Risk Adjusted Population

Wu-Chyuan Gau and John Criswell are featured speakers at the 8th Annual RISE Summit “Best Practices and Essential Strategies for Successfully Managing Risk, Quality, Revenue and Data Analytics” to be held in Nashville on March 9-11, 2014. Both speakers will share best practices, advanced strategies and unique tools for achieving care management and quality performance objectives for Medicare Advantage and Commercial Health Exchange “HIX” risk adjusted populations.

In light of recent guidance from CMS and the proposed cuts in reimbursement, payers need actionable strategies for reducing cost, optimizing risk adjustment, elevating quality performance, and boosting revenue. The combination of cuts, changes in risk adjustment as it relates to face to face assessments are challenges that will add complexity as payers attempt to achieve quality data and effective analytics to enhance member engagement, improve outcomes, and quality of care. Legacy and limited analytics tend to produce weak results that impact utilization and the ability to appropriately target members for care management. The speakers will share how new predictive models and Big Data strategies are emerging with positive results.

Featured speakers Wu-Chyuan Gau, PhD, ASA, MAAA, the predictive modeling lead with Florida Blue and John Criswell, MBA, CEO of Pulse8 will address these challenges and share strategies for utilization management control with predictive analytics in their presentation titled “Predictive Analytics and Strategies for Personalized Care Management”. Attendees will learn how big data and improved data quality enhances probability to predict members for care management.

About the Featured Speakers

Wu-Chyuan (Gary) Gau, Ph.D., ASA, MAAA, joined Florida Blue Fall 2010. He is the predictive modeling lead at Florida Blue. He co-authored book chapters for Healthcare Risk Adjustment and Predictive Modeling. Dr. Gau previously was an Associate Professor of Statistics and Actuarial Science at the University of Central Florida (UCF) where he served for seven years. Dr. Gau received his doctorate in Mathematics and Statistics from Boston University (BU) in 2003. He taught a wide variety of actuarial science and statistics classes at both UCF and BU. His research expertise is risk assessment using various data mining and predictive modeling techniques.

John Criswell, MBA is Founder and CEO of Pulse8, a cutting-edge healthcare technology and analytics provider that delivers an unprecedented view into risk adjustment so health plans can achieve the highest financial impact in the Commercial Health Exchanges and Medicare Advantage markets. Under Mr. Criswell’s direction, Pulse8 maintains its mission to help people live independent and healthy lives by leveraging evidence-based medicine and statistical analyses to define and help answer the most important questions in the evolving and complex healthcare landscape. Mr. Criswell has designed and deployed predictive and forecasting models using complex algorithms and historical and market indicators for top health plans and Fortune 50 companies. Throughout his career, his focus has been on providing exceptional performance for clients through innovative solutions that deliver significant financial results. John earned his MBA from The Johns Hopkins University and his BA in Political Science with a Minor in Business and Finance from Mount Saint Mary’s University. For more information, please contact Pulse8 at (410) 928.4218 or visit http://www.Pulse8.com and follow Pulse8 on Twitter at https://twitter.com/Pulse8News.

About the 8th Annual RISE Summit

The 8th Annual RISE Summit “Best Practices and Essential Strategies for Successfully Managing Risk, Quality, Revenue and Data Analytics” is presented by Healthcare Education Associates as the must-attend event for risk adjustment and quality improvement for plans and providers. Featuring over 30 sessions, panel discussions, unique 90-minute roundtables and case studies from leaders in risk revenue management and quality improvement. Attendees will receive updates from the Health Exchanges (“HIX”) on enrollment demographics, claims data, risk and quality. Additionally, attendees will hear directly from CMS on recent developments and the future of risk revenue. It includes renowned speaking faculty from health plans, state exchanges and service providers who will share case studies and expert presentations to its audience of actuarial analysts, CEOs, CFOs, product development and benefit design executives. For more information and to register to attend, please go to https://www.frallc.com/events/rise/Default.aspx and enter code HSM135 for a 15% discount off your admission rate.

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Selina Dennis
since: 09/2012
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Pulse8 Inc.

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